Canine infectious disease AI Flashcards
What are the common environments where Leptospira can be found?
Drainage ditches, ponds, slow flowing rivers, and lakes.
What are the sources of infection with L.Icterohaemorrhagiae for both dogs and humans?
Rats
What is the main reservoir of L.canicola?
Dogs
For how long can Leptospira be shed in the urine after clinical infection or by an asymptomatic carrier?
Many months
What is the aim of treatment for Leptospira infection?
Elimination of the renal carrier state
Under what conditions will Leptospira survive in the environment?
Sufficient humidity and moderate temperature
What activates Leptospira?
Sunlight or low/high pH
What are the routes through which infection with Leptospira can take place?
Penetrating skin or mucous membranes of oral cavity, pharynx, conjunctiva, and intestinal mucosa
After infection, what happens during the initial leptospiraemia phase?
Leptospira circulates in the blood for about one week
Which tissues do Leptospira usually localize in after the initial leptospiraemia phase?
Liver, spleen, kidneys, and lymph nodes
Which serovar tends to produce a nephropathy and severe inflammation of the interstitium?
L.canicola
Which serovar tends to produce acute hepatitis and perivascular haemorrhage with liver involvement?
L.Icterohaemorrhagiae
What happens to the levels of protective antibodies after recovery from a Leptospira infection?
They remain high for a long time
What are the common clinical signs of Leptospira infection?
Lethargy, anorexia, pyrexia, vomiting, abdominal pain, jaundice
What can pulmonary haemorrhage indicate during a Leptospira infection?
L.Icterohaemorrhagiae infection
What can uraemia with oral ulceration indicate during a Leptospira infection?
L.canicola infection
What can be a possible outcome in severe cases of Leptospira infection?
Rapid clinical deterioration and death within a few days
Which diagnostic methods can be used for Leptospira infection?
Dark field microscopy, silver staining, immunofluorescence, serology, PCR tests
What is the easiest way to distinguish Leptospira infection from vaccination titres?
A rising titre (four-fold increase)
Why is culturing Leptospira rarely undertaken?
Leptospira are hard to grow in culture
What is the recommended duration of antibiotic therapy for recovering cases of Leptospira infection?
At least two weeks
What are the current killed vaccine components for Leptospira in the UK?
L.canicola and L.Icterohaemorrhagiae
What has been recently added to the new vaccines for Leptospira due to increased incidences?
L.Copenhageni and L.Bratislava
What is the vital first step in treating Leptospira infection?
Early treatment with appropriate antibiotics
What can be necessary in severe cases of Leptospira infection with hepatic or renal involvement?
Intensive supportive therapy including IVFT, electrolyte and acid base correction, and potentially whole blood
Which cases of Leptospira infection carry a very poor prognosis?
Cases with severe hepatic or renal involvement
What is the aim of continuing antibiotic therapy in recovering cases of Leptospira infection?
To eliminate the carrier status and infection within the renal tubules
What is the purpose of the recently available bench top serology test for Leptospira?
Early diagnosis
What are the antibiotics of choice for treating Leptospira infection?
Penicillin, erythromycin, and tetracyclines
What is the disease that is also known as Alabama rot?
Idiopathic cutaneous and renal glomerular vasculopathy (CRGV) or Alabama rot.
When was the disease known as Alabama rot first discovered?
Late 1980’s.
Which breed of dogs was initially thought to be affected by Alabama rot?
Greyhounds.
Which specialist veterinary team is actively evaluating the cause of Alabama rot?
Anderson Moores Veterinary specialists (Laura Holm and David Walker) and the Royal Veterinary College.
Where have a majority of the Alabama rot cases been reported in the UK?
New Forest area.
What are the symptoms of Alabama rot?
Skin lesions and acute kidney injury (AKI).
Which areas of the dog’s body are typically affected by the skin lesions of Alabama rot?
Lower limbs, ventrum, and around the muzzle.
What is the histological finding in the kidneys of dogs with Alabama rot?
Thrombotic microangiopathy (TMA).
What are the clinical signs of acute kidney injury (AKI) in Alabama rot cases?
Vomiting, reduced appetite, pyrexia, and lethargy.
What is the cause of Alabama rot?
The cause is currently unknown.
What is the known canine disease that causes vasculopathy affecting the small vessels of the kidney and skin?
CRGV.
Which other disease is characterized by thrombotic microangiopathy (TMA) in dogs?
Haemolytic uraemic syndrome (HUS).
What are some suggested causes of CRGV?
Unknown, but possible causes include leptospirosis, borreliosis, heavy metals, and canine circovirus.
What is the main difference between CRGV and HUS in dogs?
HUS has been reported in dogs of different breeds, while CRGV has only been reported in Greyhounds.
What is a common cause of HUS in humans?
E. coli or Shigella dysenteriae shiga toxin.
What usually precedes the signs of HUS in humans but not in dogs with CRGV?
Diarrhea.
What is the mnemonic used to remember the relationship between specificity and a positive result?
Sp-P-in - a high Specificity, a Positive result rules In the diagnosis.
What do specificity and sensitivity relate to?
The performance of a diagnostic test when compared to a gold standard reference in a test population.
What do predictive values take into account?
The disease prevalence in the test population.
What does prevalence refer to in the context of disease?
The number of patients within a population that have a particular disease at a specific time.
How is positive predictive value calculated?
By dividing the number of animals with true positive results by all animals that give positive results with the test (true and false positives).
What does a high positive predictive value indicate?
A positive test result reliably indicates the presence of disease in a patient.
How is negative predictive value calculated?
By dividing the number of animals with true negative results by all animals that give negative results with the test (true and false negatives).
What does a high negative predictive value indicate?
A negative test result reliably indicates the absence of disease in a patient.
What happens to the predictive value of a negative test with decreased prevalence?
It improves.
What happens to the predictive value of a positive test with increased prevalence?
It improves.
What happens to the predictive value of a negative test with increased sensitivity?
It improves.
What happens to the predictive value of a positive test with increased specificity?
It improves.
What is the severity of leptospirosis?
The disease is potentially fatal, especially in unvaccinated animals.
Which serovars of Leptospira interogans are most commonly seen in dogs?
L.canicola and L.Icterohaemorrhagiae.
What is the geographical distribution of L.Icterohaemorrhagiae and L.canicola in the UK and Europe?
Widespread, although the incidents of L.canicola has fallen in recent years.
What is leptospirosis?
It is caused by spirochetes of the serovars of Leptospira interogans and is an important zoonosis.
What does leptospirosis cause?
Various signs can vary, and the disease is potentially fatal, especially in unvaccinated animals.
Are the individual serovars of leptospirosis distinguishable morphologically?
No.
What is the purpose of PCR?
To amplify DNA or RNA for detection
What is the process called when RNA is transcribed back to DNA before amplification?
Reverse transcription or RT-PCR
What is the advantage of PCR tests?
They are very sensitive and give rapid results
What does PCR only tell you about?
The presence of the antigen
What can PCR detect even if the organism is dead?
DNA
What can serology detect?
Antibodies or immunoglobulins formed against infections
Which antibody is typically produced early in an infection?
IgM
What is the lag period between IgM production and IgG production called?
Seroconversion
How can exposure or previous antibody responses be determined in some cases?
Taking pair convalescence titres after 10-14 days
What is the expected increase in antibody levels after 10-14 days?
A 4 times increase
What are some methods used for measuring antibody levels?
ELISA, immunofluorescent assays, and western immunoblotting
How long are antibodies stable in refrigeration?
Around 7-10 days
When should serum samples be frozen if stored for longer periods?
Longer than 7-10 days
What characteristics define diagnostic tests?
Sensitivity and specificity
What does the sensitivity of a test measure?
The true positives divided by the true positives and false negatives
What mnemonic is used to remember the relationship between sensitivity and a negative result?
Sn-N-out
What does the specificity of a test measure?
The true negatives divided by the true negatives and false positives
How can a negative result of a test with high specificity help?
In excluding the diagnosis
Who is the module developer for Canine Infectious Diseases?
Simon Tappin
What are the learning objectives for this module?
- Explain diagnostic tests for infectious diseases. 2. Understand false positive and false negative test results. 3. Know sensitivity and specificity in infectious disease. 4. Consider disease prevalence and predictive values. etc.
What is the principle of diagnosing an infectious disease?
Specific tests detect the presence of the organism or evidence of infection through immune response.
What factors are helpful in directing investigations for infectious diseases?
Consistent history, clinical signs, and considering the type of organism suspected.
Why is a cystocentesis urine sample more appropriate than a free catch sample?
Cystocentesis reduces contamination risk for evaluating potential urinary tract infections.
How can a pooled sample be useful in diagnosing certain infections?
A pooled sample over 3 days improves the likelihood of finding intermittently excreted faecal pathogens like Giardia.
What is one standard way to document the presence of infection?
Culturing the organism allows rapid identification and assessment of antibiotic therapy.
What is the minimal inhibitory concentration (MIC)?
It is the lowest antimicrobial concentration that inhibits macroscopic bacterial growth.
How quickly should urine grows be present in the laboratory?
Urine grows should be present within 24 hours for identification and antibiotic assessment.
What are the considerations for handling samples?
Samples should arrive quickly, replicate the sample environment, and follow proper handling and storage techniques.
How many doses of vaccine are needed for immunity?
Two doses
At what age is the first dose of vaccine usually given?
6 to 9 weeks
At what age is the second dose of vaccine usually given?
10 to 12 weeks
Do killed vaccines provide prolonged immunity?
No
Is annual revaccination necessary for killed vaccines?
Yes
What can Leptospira cause in humans?
Serious disease
What is the most common risk for developing leptospirosis?
Swimming in infected waterways
How does human disease usually present?
Flu-like symptoms
What can flu-like symptoms progress to if not treated effectively?
Severe renal or hepatic signs and even death
What has caused an increase in feline cases of leptospirosis?
Exposure to rodents while hunting
Are feline cases of leptospirosis treated similarly to dog cases?
Yes
Where can further information on Leptospira be found?
ACVIM and European consensus statements
When was Angiostrongylus vasorum first documented?
1853
What are the clinical signs of Angiostrongylus vasorum infection?
Respiratory, coagulopathic, and neurological signs
Where are the geographic hotspots for Angiostrongylus vasorum in the UK?
South west and south east England, and south Wales
What are the primary hosts for Angiostrongylus vasorum?
Domestic dogs and foxes
How do dogs become infected with Angiostrongylus vasorum?
Eating infected intermediate hosts or paratenic hosts
Where do larvae of Angiostrongylus vasorum migrate to mature?
Pulmonary vasculature
What is the variable pre-patent period for Angiostrongylus vasorum?
28 to 108 days
Where do the ova of Angiostrongylus vasorum develop into larvae?
Pulmonary capillaries and alveoli
How long can untreated dogs excrete Angiostrongylus vasorum larvae post-infection?
Nearly 2 years
Where is the distribution of Angiostrongylus vasorum patchy but fairly widespread?
Most of Western Europe
What are the historically well-defined areas of infection in the United Kingdom?
Cornwall and south Wales
What are the potential causes of the change to the reported distribution of Angiostrongylus vasorum?
Changes to environmental conditions, increased abundance of mollusc hosts, and better awareness of clinical signs
Which breed of dogs were found to be at higher risk of Angiostrongylus vasorum infection in southern England?
Cocker, Springer and Cavalier King Charles Spaniels, Jack Russell and Staffordshire Bull Terriers
What tests are traditionally used to diagnose Angiostrongylus vasorum?
Modified Baermann floatation, direct faecal smear, tracheobronchial secretions or tracheal wash samples, and PCR tests
What is the sensitivity of a direct faecal smear test for Angiostrongylus vasorum?
54-61%
What is the sensitivity of an in-house ELISA test for Angiostrongylus vasorum?
85 - 96%
What imaging findings can provide supportive evidence of Angiostrongylus vasorum infection?
Patchy alveolar pattern in the peripheral lung fields
What hematological finding is commonly reported in Angiostrongylus vasorum cases?
Eosinophilia
What biochemical finding is commonly reported in Angiostrongylus vasorum cases?
Hyperglobulinaemia
In some cases of Angiostrongylus vasorum infection, what has been reported in terms of calcium levels?
Hypercalcaemia
What are the two focuses of treatment for Angiostrongylus vasorum infection?
Killing the parasites and supportive therapy.
What are the two licensed products to treat Angiostrongylosis in the United Kingdom?
Imidacloprid/moxidectin (Advocate®) and mibemycin/praziquantel (Milbemax®).
How is Advocate® administered for the treatment of Angiostrongylosis?
As a monthly spot-on.
How are Milbemax® tablets administered for the treatment of Angiostrongylosis?
Orally once a week for four weeks.
What is the efficacy of imidacloprid/moxidectin in treating Angiostrongylus stages?
85% according to a blinded randomised controlled field study.
What is the recommended dose of fenbendazole for treating Angiostrongylus vasorum?
25-50mg/kg SID for 3-21 days.
What signs are most commonly seen in dogs with Angiostrongylosis?
Cardiorespiratory signs, including coughing.
When may steroids need to be administered to dogs with Angiostrongylosis?
If respiratory signs worsen after adulticides are administered, especially if worms are killed rapidly.
What type of therapy is usually not needed for Angiostrongylus vasorum infection?
Antimicrobial therapy, unless there is secondary bacterial infection.
What is occasionally indicated for the treatment of severe pulmonary hypertension in dogs with Angiostrongylosis?
Sildenafil.
What is the cause of bleeding in patients with Angiostrongylosis?
It is not well understood and likely has many factors.
What are the clinical findings and experimental work suggesting about Angiostrongylus vasorum?
It triggers a compensated state of disseminated intravascular coagulation (DIC).
What may be required if bleeding is clinically significant in patients with Angiostrongylosis?
Whole blood or fresh frozen plasma.
What is the preventative use of Advocate® and Milbemax® for Angiostrongylus?
Four weekly administrations to reduce parasite burden.
What are some other measures to reduce the risks of exposure to Angiostrongylosis?
Removing toys from the garden overnight, limiting access to areas with slugs and snails, and regular removal of faecal matter.
What is the treatment for acute kidney injury (AKI) in dogs?
Intravenous fluid therapy and supportive treatment including continuous renal replacement therapy.
What is the only definitive method of confirming the disease CRGV?
Histopathology (plasma exchange suggested as a possible treatment option).
Which canine breed is commonly affected by cutaneous and renal glomerular vasculopathy?
Greyhounds.
What is the cause of seasonal canine illness (SCI)?
Currently unknown, ongoing research to find the cause.
When are cases of seasonal canine illness (SCI) usually seen?
Between August and November, with most numbers reported in September.
What are some potential causes investigated for the cause of SCI?
Harvest mites, toxins from plants, fungi, and algae blooms.
What are some reported signs of seasonal canine illness (SCI)?
Sudden onset gut upset, vomiting, diarrhea, lethargy, abdominal pain, loss of appetite, pyrexia, tremors, rash.
What percentage of dogs died from SCI in 2010?
20% of the dogs developing this syndrome died.
What is the lowest concentration that inhibits growth of microorganisms?
The MIC (Minimum Inhibitory Concentration)
What is the purpose of culturing fungal samples in a designated laboratory?
To assess for zoonotic risk and perform antifungal sensitivity testing.
What is the alternative to viral culture now that PCR tests are widespread?
PCR tests for detecting viral presence.
What can direct assessment of samples like aspirates and urine provide?
Rapid assessment of bacterial presence and likely type of infection.
What stain can be used to differentiate Gram-positive and Gram-negative bacteria?
Gram staining.
What stain is used to detect acid-fast bacteria, such as mycobacteria?
Ziehl-Neelson staining.
What stains can be used to identify fungi?
Potassium hydroxide on skin samples and Periodic acid–Schiff (PAS) stains.
What types of tests allow detection of microorganism antigens?
ELISA, direct immunofluorescent (IFA), indirect immunofluorescent, and microscopic agglutination assays.
What technology is used to detect DNA or RNA of microorganisms?
Nucleic acid technology, such as Fluorescence in situ hybridization (FISH) assays and PCR.
What is the purpose of real-time or quantitative PCR?
To quantify the amount of DNA from microorganisms.
What is the percentage of cases of SCI in 2012?
2%
What may cause a weak positive result on ELISA tests for CPV?
Vaccination with a modified live CPV vaccination may cause a weak positive result.
How long can a weak positive result last on ELISA tests post-vaccination?
A weak positive result can last for 5 to 15 days post-vaccination.
Is ELISA snap test sensitivity comparable to PCR or electron microscopy?
ELISA snap tests are less sensitive when compared to PCR or electron microscopy.
When should PCR-based methods be used to confirm negative results on ELISA tests?
PCR-based methods should be used when a patient testing negative on in-house tests still has a clinical suspicion of CPV.
Are PCR tests more sensitive than conventional methods for detecting CPV antigens in faeces?
PCR tests have higher sensitivities than conventional methods of viral antigen determination in faeces.
What can real-time PCR identify in dogs shedding CPV in their faeces?
Real-time PCR can identify dogs shedding low titres of CPV in their faeces.
What can serology (using haemagglutination inhibition) be used to document?
Serology can be used to document an immune response to CPV, indicating a current or previous infection.
When do antibodies to CPV become detectable?
Antibodies to CPV become detectable when clinical signs are first seen.
Can a single positive serology alone confirm active CPV infection?
A single positive serology is not diagnostic for active CPV infection.
What is required along with consistent clinical signs to diagnose current CPV infection by serology?
Detection of anti-CPV IgM or a rising IgG titre is required along with consistent clinical signs.
What cleaning methods are effective in eliminating CPV from the environment?
Hypochlorite solutions and steam cleaning are effective in eliminating CPV from the environment.
What are the aims of fluid therapy in treating CPV?
The aims of fluid therapy are to treat shock, correct dehydration, and anticipate loss from ongoing diarrhoea and vomiting.
What should be given by rapid infusion to improve peripheral perfusion in patients presenting in shock?
A bolus of 10-20ml/kg of a balanced electrolyte solution (e.g. lactated Ringers solution) should be given by rapid infusion.
What signs indicate improved peripheral perfusion in patients receiving fluid therapy for CPV?
Improvement in peripheral pulse quality, reduction of heart rate, and improved demeanour indicate improved peripheral perfusion.
How long can boluses be repeated if there is no improvement in peripheral perfusion?
Boluses can be repeated up to 60-90ml/kg if there is no improvement in peripheral perfusion.
What is Canine Respiratory coronavirus (CRCoV)?
Canine Respiratory coronavirus (CRCoV) are RNA viruses with large club-like projections on their outer surface.
What are the signs of Canine Respiratory coronavirus (CRCoV) infection?
Canine Respiratory coronavirus (CRCoV) alone does not cause clinical signs, but it can lead to damage to the respiratory mucosa and predispose to secondary infection.
How is Canine Respiratory coronavirus (CRCoV) diagnosed?
Canine Respiratory coronavirus (CRCoV) is diagnosed using PCR.
Is there a vaccine available for Canine Respiratory coronavirus (CRCoV)?
At this point, there is no vaccine available for Canine Respiratory coronavirus (CRCoV).
What are the potential complications of Canine Respiratory coronavirus (CRCoV) infection?
Complications of Canine Respiratory coronavirus (CRCoV) infection include reversible damage to the respiratory mucosa, leading to a predisposition to secondary infection.
What precautions should be taken to minimize the risk of outbreaks of Infectious Tracheobronchitis (ITB)?
Environments with a large, transient population of dogs should maintain exemplary hygiene measures to minimize the risk of outbreaks of Infectious Tracheobronchitis (ITB).
What antibiotics can be used in cases of suspected Infectious Tracheobronchitis (ITB)?
In cases of suspected Infectious Tracheobronchitis (ITB), suggested antibiotic choices include Doxycycline, Trimethoprim/sulphonamide, and Potentiated amoxicillin.
Which medications may be helpful in uncomplicated cases of Infectious Tracheobronchitis (ITB) with severe coughing?
In uncomplicated cases of Infectious Tracheobronchitis (ITB) with severe coughing, anti-tussives (butorphanol or prednisolone) and/or bronchodilators (theophylline, terbutaline) may be helpful.
What should be avoided when using anti-tussives in cases of Infectious Tracheobronchitis (ITB)?
Anti-tussives should not be used in cases with severe airway secretions or bronchopneumonia. Nebulization and coupage would be indicated in these cases.
What is the cause of tetanus infections?
Tetanus infections are caused by the anaerobic bacterium Clostridium tetani.
Where is Clostridium tetani commonly found?
Clostridium tetani is widespread in the soil and animal feces.
What are the toxins produced by Clostridium tetani?
Clostridium tetani produces tetanolysin and tetanospasmin, with tetanospasmin causing the clinical effects.
How does tetanospasmin affect the body?
Tetanospasmin binds to the axons of peripheral nerves, preventing the release of glycine and causing overactivity of motor neurons.
How is infection with Clostridium tetani usually acquired?
Infection with Clostridium tetani is usually acquired through a penetrating wound that introduces spores into an anaerobic environment.
Where are the most common sites of tetanus infection?
Wounds are usually found around the feet, but bite wounds, non-healing infections, and surgery sites can also be sites of tetanus infection.
What is cryptogenic tetanus?
Cryptogenic tetanus refers to cases where a wound is never identified, and the site of infection is not found.
Are dogs and cats sensitive to tetanus?
Dogs are 600 times less sensitive to tetanus compared to horses, and cats are 7200 times less sensitive than horses.
What are the clinical signs of tetanus infection in dogs?
Clinical signs of tetanus infection in dogs include retracted lips causing a ‘sardonic grin’, erect ears, trismus (lock jaw), and a stiff gait.
What complications can arise from tetanus infection?
Complications of tetanus infection in animals include respiratory distress, aspiration pneumonia, arrhythmia, disseminated intravascular coagulation (DIC), and hyperthermia.
What are the focal signs commonly seen in tetanus infection in cats?
Cats more commonly have focal signs compared to dogs, with extensor rigidity in a single limb.
What are the classic history and clinical exam findings for tetanus infection?
History and clinical exam findings are typically classic for tetanus infection.
What are the signs of chronic Ehrlichia canis infection?
Bone marrow hypoplasia, pancytopenia, thrombocytopenia, and platelet dysfunction.
Why do only some dogs develop signs of chronic Ehrlichia canis infection?
The reason is not clear, but it appears to be more common in German shepherd dogs.
Which organ system is important in determining the pathogenesis of chronic Ehrlichia canis infection?
The spleen and its mononuclear phagocytic system.
What is the prognosis associated with chronic Ehrlichia canis infection?
The prognosis is very guarded.
What does biochemistry usually reveal in the phase of chronic Ehrlichia canis infection?
A marked increase in globulins.
What diagnostic method can be used to identify Ehrlichia morulae in leucocytes?
Microscopic examination of blood collected from a peripheral capillary vessel or buffy coat analysis.
What is the serological evidence of exposure to Ehrlichia canis?
Immunofluorescence antibody titres >40 to 80.